Let’s start off with a few simple propositions. Pain is just an extension of touch. We feel some levels of pressure represent pleasure or are merely acceptable. If the pressure becomes uncomfortable, we are immediately alerted. If the discomfort turns into pain, we are motivated to take action. So the gradations of touch into pain are a necessary part of the bodily process allowing us to avoid injury in our dangerous modern environment. Sadly, we do not have the means to switch off pain selectively. We continue to feel some pain unless the drugs literally induce unconsciousness. This is reality. There’s no sense in trying to deceive ourselves. So the big question is how we organize our lives to live a satisfying life with continuing pain?

This is not what you want to hear. The marketers who aim to sell you the range of drugs produced by the pharmaceutical industry have been brainwashing you for decades. They want you to believe there’s a pill to cure all your ills. Except that has always been a lie. Although some drugs are very effective for a time, all drugs slowly lose their effectiveness as the body adapts to them. This leaves you with the choice of giving up the drugs or increasing the dosage and risking dependence. In fact, we have millions of people addicted to prescription drugs. The majority could not stop without experiencing unpleasant withdrawal symptoms.

Long ago, the Europeans decided this was unacceptable so they have been working to change mindsets. People have to understand they cannot rely on drugs to solve their long-term health problems. They must become more self-sufficient. This is what pain management really means. Specialists have to teach people how to live without becoming dependent on drugs. It all starts with a thorough re-evaluation of the medical treatment to date. Fresh pairs of eyes look back through the records of surgical procedures and other therapies. If anything has been missed, they are now done. If anything may have been done wrongly, attempts are made to correct any adverse consequences. The idea is to ensure everything that can be done to treat the underlying cause of the pain has been done.

Now we come to the pain itself. This is recognized as a medical problem in its own right. There are specialist physicians and highly trained therapists grouped together in dedicated units. Their job is to evaluate each patient and devise a personal regime for maximizing the quality of life. It starts with occupational therapists who visit homes and workplaces, suggesting how living spaces can be designed to reduce problems, and looking to see if jobs can be redefined to reduce the causes of pain. Then come the physical therapists to introduce exercises and activity programs to rebuild strength and improve mobility. Finally, the cognitive behavioral therapists teach practical strategies for staying positive when life seems difficult. All the evidence shows this team approach is very effective. Making the patient the center of attention improves morale and fights off the threat of depression. This is not to deny the importance of a drug like Ultram. There can be a flare-up of pain and, as a short-term response, a painkiller can be essential. But, as soon as possible, the Ultram must go back into the cabinet. Life must go on without drugs.

There’s a rumor going round the town that pain is a bad thing and should be eliminated at all costs. Big Boss Pharma has been lining up all its big guns and, no matter what level of pain you may be experiencing, there’s a pill with your name on it, assuming you get a prescription, of course. You may therefore look at the headline here and be a little surprised. How on Earth can anyone think pain is a good thing? Well, let’s go back to basics. Darwin, that inconvenient man who thinks we all evolved rather than were created, argued only the best-adapted species survived. When it comes to survival, the animal needs to know when it’s under attack. If it’s injured, it decides whether to fight or flee. So pain is a vital signal to the brain. It warns when the body is injured. We benefitted from that when we were less well-developed. Today, it’s still useful to know if we have accidentally injured ourselves or just picked up something too hot to hold.

The modern response is to seek medical assistance and then we complain when the pain message continues. So let’s move medical science a few years into the future. Rather in the same way we can switch off the burglar alarm when we know someone has broken into our home, a researcher develops a magic pill to switch off pain. It changes the brain’s chemistry so we are no longer aware of any pain. Would you take it? Before you rush to an answer, the scientist confirms this is an all or nothing pill. Either you feel pain or you do not. We will have to go into real science fiction to arrive at a treatment that only switches off the pain messages from the injured part of the body. In theory, it should be possible to neutralize the pain by interrupting the nervous system at key junctions, e.g. where an arm or leg joins the body. Unfortunately, this also risks paralyzing the arm or leg.

Anyway, back to the question. Would you take a pill to switch off pain? It would mean you would not know if you were damaging any other part of your body. Suppose you drink something that’s burning your tongue, or slip and make your existing injury worse. You would not know to stop drinking or seek further medical treatment. Completely turning off pain is dangerous unless you lie perfectly still and take no physical risks. Even then, you would not know if you were getting the first pain symptoms of a heart attack or warning indications of any other disease. The present situation is safer because a drug like Ultram simply reduces the intensity of the current pain. You can still feel if any other part of your body is injured or you are affected by some other disease or disorder.

In Europe, the trend is to teach people pain management techniques so they can achieve a good quality of life without having to rely on painkillers. This does not deny a role for drugs like Ultram. They will still be used for short-term relief should pain flare up. The hope is people can cope without risking dependence on drugs.